Effects of childhood exposure to PM2.5 in a Memphis pediatric asthma cohort

The effects of childhood exposure to ambient air pollution and their influences on healthcare utilization and respiratory outcomes in Memphis pediatric asthma cohort are still unknown. This study seeks to (1) investigate individual-level associations between asthma and exposure measures in high asthma rate and low asthma rate areas and (2) determine factors that influence asthma at first year of a child's life, first 2years, first 5years, and during their childhood. Datasets include physician-diagnosed asthma patients, on-road and individual PM2.5 emissions, and high-resolution spatiotemporal PM2.5 estimates. Spatial analytical and logistic regression models were used to analyze the effects of childhood exposure on outcomes. Increased risk was associated with African American (AA) (odds ratio (OR)=3.09, 95% confidence interval (CI) 2.80-3.41), aged <5years old (OR=1.31, 95% 1.17-1.47), public insurance (OR=2.80, 95% CI 2.60-3.01), a 2.5-km radius from on-road emission sources (OR=3.06, 95% CI 2.84-3.30), and a 400-m radius from individual PM2.5 sources (OR=1.33, 95% CI 1.25-1.41) among the cohort with residence in high asthma rate areas compared to low asthma rates areas. A significant interaction was observed between race and insurance with the odds of AA being approximately five times (OR=4.68, 95% CI 2.23-9.85), public insurance being about three times (OR=2.65, 95% CI 1.68-4.17), and children in their first 5years of life have more hospital visits than other age groups. Findings from this study can guide efforts to minimize emissions, manage risk, and design interventions to reduce disease burden.